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Dentigerous cysts in young adults may compromise the natural evolution of the dentition and can be treated surgically or non-surgically. We report the minimally-invasive treatment of dentigerous cysts in two young patients using a modified Hawley plate to avoid traumatic injury to anatomical structures, with up to four years' follow up., (Copyright © 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

We prospectively investigated in adults the decompression of dentigerous cysts associated with impacted third molars at high risk of iatrogenic damage during extraction. The computerised calculated volumetric postoperative reductions measured by cone-beam computed tomography at four and eight months were correlated with the duration of treatment, initial volume, and patient's age. We prospectively monitored 14 adult patients with 14 dentigerous cysts that were associated with impacted third molars, for eight months after decompression. The mean (SD) reduction in volume during the first eight months was 71 (14) % (51% after the first four months and 20% after the second four months), with a monthly reduction rate of 9%. Both the total decrease in volume (a) and the monthly rate of reduction (b) were significantly associated (p<0.01) and linearly correlated with the duration of decompression [r (a)=-0.89, r (b)=-0.61] and initial volume [r (a)=r (b)=0.92], but not with the patient's age (p=0.49) [r (a)=r (b)=0.04]. The trend towards reduction in volume within a period of eight months of treatment allowed us to better understand the duration of decompression required., (Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

There is a resurgence of interest in coronectomy, but its appropriate application in the management of third molar teeth has yet to be defined. Dentigerous cysts associated with unerupted teeth are most commonly associated with mandibular third molars. In this case series we evaluate outcome after coronectomy of teeth with associated dentigerous cysts in cases where the inferior dental nerve was thought to be at risk, or there was an increased risk of mandibular fracture. We retrospectively studied 21 consecutive patients treated by coronectomy for dentigerous cysts at the Oral Surgery Department at Guy's Hospital. The most commonly affected teeth were mandibular third molars (20/21). One patient had permanent injury to the inferior dental nerve, but no mandibular fracture or recurrence of cyst was reported. One patient required secondary retrieval of the retained root because of eruption. Coronectomy of unerupted teeth associated with dentigerous cysts is an effective treatment when there is high risk of injury to the inferior dental nerve injury or potential for mandibular fracture. Further work with larger numbers and longer follow-up is required to discover the long-term outcome of the electively retained root., (Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Marsupialisation, by which a surgical window is created in the cavity of a cystic lesion, has been recommended to avoid the formation of a bony defect in the jaw and a reduction in a patient's quality of life. However, information about the factors that affect the reduction in the size of a cyst after marsupialisation is limited. We have studied the effects of the patient's age and the size of the primary lesion on the speed of shrinkage after marsupialisation of keratocystic odontogenic tumours (KCOTs), dentigerous cysts, and radicular cysts. The speed of shrinkage (mm(2)/month) was evaluated by measuring the radiolucent area on panoramic radiographs taken before and after marsupialisation for KCOT (n=28), dentigerous cysts (n=26), and radicular cysts (n=18) in the mandibular molar regions. The mean duration of marsupialisation for each type of cyst was 11 (5), 8 (5), and 5 (2) months, respectively. The radiolucent area decreased linearly in the 3 types depending on the time after marsupialisation: r=-0.86 (p<0.01), r=-0.73 (p<0.01), and r=-0.72 (p<0.01), respectively. The relative speed of shrinkage did not correlate with the age of the patients, though it did correlate with the size of the radiolucent area before marsupialisation in KCOT (r=0.69, p<0.01) and radicular cysts (r=0.73, p<0.01). These results suggest that the size of a cyst before marsupialisation may affect the speed of shrinkage in KCOT and radicular cysts, while the age of the patient does not., (Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Descending necrotizing mediastinitis is a potentially fatal condition which may occur seldom as a consequence of oral infections. This report describes the management of a patient with mediastinitis due to an infected dentigerous cyst.

A case is presented of simultaneous adjacent odontogenic keratocyst and dentigerous cyst occurring in the same quadrant. Their in vivo behaviour, influence and effect on each other, surrounding tissues and on tooth development over a period of 4 years are described. This unique case may further advance the understanding of the behaviour of the odontogenic keratocyst in vivo.

A prospective study was conducted on 82 odontogenic keratocysts (OKCs) diagnosed in 80 patients over a 25 year period. The clinical and radiographic data were correlated, which resulted in an accurate picture of the clinical presentation, relationship with teeth and incidence of lingual perforations in mandibular OKCs. In 40% of the cysts no suspicion had arisen before surgery, in 60% the diagnosis was secured before surgery. This last group of patients was treated according to a defined protocol, with the exception of the maxillary OKCs, which entailed excision of the attached, overlying mucosa and enucleation of the cyst after which the defect was treated with Carnoy's solution. The other patients underwent just enucleation of the cysts. For the first 5 years the patients were seen every year, thereafter every 2 years if possible. Recurrences (9/82) were mainly found in the patients in which the cyst had just been enucleated. Only three cysts recurred in the group treated according to the above mentioned protocol. Most recurrences presented within 5 years, but late recurrences did occur even after 25 years. The aetiology and pathogenesis of OKCs is briefly discussed in the light of the present findings. It is concluded that the suggested treatment protocol and follow-up schedule provides a safe means to manage a lesion that is known to recur and may even give rise to life threatening situations.

Jaundice developed in two patients following dental operations under general anaesthesia. Gilbert's Syndrome was established as the diagnosis. Caloric deprivation at the time of surgery resulted in the increased plasma concentration of unconjugated bilirubin. The pathogenesis of this not uncommon disorder and the mechanism of fasting hyperbilirubinaemia is discussed.